Jessica Bleaman, 21, responded in 2009 to an ad from 1-800-GET-THIN, the outfit that has been touting weight-loss surgery incessantly in the Southland via broadcast commercials and freeway billboards. Her experience with the gastric-banding purveyors didn't turn out well, but her alleged medical problems were only part of it.

For months after her surgery, she said, she suffered pain and vomiting, and in 2010 she underwent a second operation at a clinic affiliated with the billboard campaign. After her parents' insurance company rejected most of the $78,760 charged for the various procedures, the parents paid the providers $5,000 to settle up the balance, according to Jessica's father, Bruce. The family figured that was the end of it, he says.

But a few weeks ago, the family received a letter from Skin Cancer and Reconstructive Surgery Specialists of West Hills (which didn't directly provide her care but uses the same address as the clinic where she had her 2010 operation). The letter said Jessica would continue to be dunned for unpaid bills unless she signed up with Patient Advocacy Law Group, which the letter said could help her fight with her insurer.

Enclosed was a retainer agreement for PALG and a form on its letterhead authorizing its lawyers to deal with her insurer on her behalf, at no cost to Bleaman. "You must act or your rights will be gone forever," the letter warned, "which means you may be responsible" for the unpaid bills. If she signed with PALG, the collection efforts would stop "until PALG fully resolves your case."

Bruce Bleaman was taken aback by the letter. "Surprised would be a mild way of putting it," he told me. In part that was because Jessica had already joined a lawsuit against 1-800-GET-THIN alleging insurance fraud, false advertising and other consumer offenses.

He was right to be surprised. PALG isn't just merely a "nonprofit law group" that "assists patients in obtaining the benefits they are lawfully entitled to receive," as the letter stated. The two attorneys who incorporated PALG -- Edmond DeFrank and Robert Silverman -- have both done legal work for 1-800-GET-THIN.

That fact was not disclosed in the PALG attorney-client agreements that were sent with the letter, according to the copy provided to me by Bleaman's attorney.

Bleaman wasn't the only recipient. A nearly identical version was sent to a different patient by another clinic affiliated with 1-800-GET-THIN. Attorney DeFrank says he doesn't know how many of these letters went out, but he said in an email that he asked the senders to stop because PALG did not want to get "mass inquiries."

The State Bar of California's ethics rules frown on misleading come-ons for attorneys that are aimed at prospective clients -- especially communications involving "coercion, duress, compulsion, intimidation [or] threats." Diane Karpman, an expert on legal ethics based in Los Angeles, didn't get into the specifics of this case but said that the core of attorneys' ethical obligations is "absolute honesty and candor."

Do the PALG letters constitute "coercion," "compulsion" or a "threat"? It's unclear if they meet the technical definition of those terms in the state bar's lexicon. But considering that the letters state "we will be forced to attempt to collect directly from you" unless you retain PALG, it's certainly in the ballpark. Both letters state that the sender "works with" PALG, which has "agreed" to provide its services at no charge to the patient.

The 1-800-GET-THIN ads tout the safety and efficacy of the Lap-Band operation, which involves implanting a silicone device around the stomach to suppress appetite. Callers to the 800 number typically are steered to surgical clinics and doctors.

The people who have been behind this campaign and some of the clinics are Julian and Michael Omidi. Julian Omidi's medical license has been revoked by the California Medical Board. The board placed Michael, a doctor, on three years' probation in 2008; his probation was completed this week.

Of the physicians who treated Bleaman after she responded to the GET-THIN ad, according to her lawsuit, one was under investigation by the medical board for negligence at the time (he has since stipulated to a public reprimand) and another had been placed on probation after a conviction for assault with a meat cleaver.

As we've reported, five people have died after Lap-Band surgeries at clinics connected to the 1-800-GET-THIN campaign and the Omidis. Three of those people had their operations at the same Beverly Hills clinic as Bleaman.

According to papers on file with the California secretary of state, PALG was incorporated by DeFrank and Silverman, who were listed as its directors, last November. DeFrank said in an email that he is a "personal friend" of Julian Omidi's and worked with Silverman to register 1-800-GET-THIN as a trademark with the U.S. patent office.

Silverman is an attorney who has represented the Omidis, 1-800-GET-THIN and the clinic where Bleaman had her second surgery. On behalf of the Omidi brothers or 1-800-GET-THIN, he has filed two libel lawsuits in state court and a trademark infringement lawsuit in federal court against me, my colleague Stuart Pfeifer and The Times. This summer, judges dismissed all three as baseless.

U.S. District Judge Otis D. Wright, in dismissing the federal lawsuit with prejudice, found that Silverman's case for 1-800-GET-THIN was so lacking in merit that even allowing him to try to amend it to overcome its deficiencies would be "futile."

In the state court cases, Silverman's clients have been ordered to pay The Times' legal fees, to the tune of more than $83,000. Silverman's clients are appealing the three dismissals.

Silverman said that he had only brief involvement with PALG. In a Sept. 8 email, he told me that he resigned his position as a PALG director "shortly after the inception of the organization," but declined to provide me with documentation.

PALG, however, did file a new disclosure document with the secretary of state showing DeFrank as its sole director -- on Sept. 8, the day after I called the PALG office to ask about its relationship with Silverman. Four days later, Silverman sued me again.

DeFrank says the letters sent to patients weren't initiated by PALG and were sent out without its consent. He doesn't believe they count as "a solicitation of business by PALG" under California bar rules.

When I asked how the clinics got their hands on PALG's client agreement and its letterhead, he replied that such documents "are readily available upon request to numerous providers for their patients that are in need of free legal assistance."

DeFrank said that if I had any questions about the letters I should ask "the sender." Both letters I've seen were sent out by healthcare entities that have been affiliated with Michael Omidi, according to public records.

I've been urging the state's medical regulators to take a close look at the 1-800-GET-THIN marketing campaign and its affiliated medical providers. To date, there's no public evidence that the medical board or California Department of Public Health have been roused from their slumber.

Now there are questions about the legal representation the patients are being urged to obtain. Will the state bar prove to be as sleepy?

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